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Otitis media in children: seasonal changes and socioeconomic level
Lucio A Castagno1, Luiz Lavinsky
1Clínica Dr. Castagno, Rua General Osório, 1585, 96020 000, Pelotas, RS, Brazil. castagno.sul@terra.com.br
Insights
Lower socioeconomic children experience a winter peak in serous otitis media (SOM). Early tympanometry findings and socioeconomic status predict poor SOM resolution, highlighting the need for targeted interventions.
Area of Science:
- Pediatrics
- Otolaryngology
- Public Health
Background:
- Otitis media (OM) is a common childhood illness with varying prevalence.
- Socioeconomic status and seasonal changes are suspected to influence OM incidence.
Purpose of the Study:
- To investigate the frequency of otitis media (OM) in relation to socioeconomic factors and seasons.
- To identify risk factors for persistent middle ear effusion in young children.
Main Methods:
- A prospective, longitudinal study followed 156 children aged 3-4 years from higher (AB) and lower (CD) socioeconomic groups.
- Children were assessed using otoscopy and tympanometry during fall, winter, and spring.
Main Results:
- Secretory otitis media (SOM) was significantly more frequent in the lower socioeconomic group (CD), peaking in winter (81% prevalence).
- Children in group CD showed a higher incidence of SOM (72.9%) in winter compared to group AB (18.4%).
- A type B tympanogram in fall predicted persistent middle ear effusion into spring, especially in group CD.
Conclusions:
- Lower socioeconomic status is associated with a winter peak in serous otitis media (SOM).
- Early detection of middle ear effusion (type B tympanogram) in the fall, combined with lower socioeconomic status, indicates a poorer prognosis for spontaneous SOM resolution.
Objective:
Our objective was to determine the frequency of otitis media (OM) in relation to socioeconomic and seasonal factors in a city in southern Brazil.
Methods:
A prospective, longitudinal study was carried out with a 3-4-year-old cohort of children randomly selected in schools serving populations of higher socioeconomic status (AB; monthly family income >10 minimum wages, US$ 1000) or lower socioeconomic status (CD; monthly family income < or = 3 minimum wages, US$ 300). The children were assessed in the fall, winter, and spring of 1997 using otoscopy and tympanometry.
Results:
Among 156 children who finished the study, 53.8% belonged to socioeconomic group CD. Otoscopy suggested chronic suppurative otitis media (OM) (tympanic membrane perforation or otorrhea) in <6% of children in the CD group, with no seasonal variation. Alterations suggesting secretory otitis media (SOM) were significantly more frequent in the CD group (P< or = 0.001), with a peak in the winter. The prevalence of SOM on otoscopy was: fall (20.9% AB; 38.1% CD); winter (28.6% AB; 81% CD), and spring (23% AB; 49.3% CD). The incidence of SOM in the winter according to tympanometry was 18.4% (group AB) and 72.9% (group CD). Among children with a normal tympanogram in the fall, 44.7% presented a type B tympanogram (presence of middle ear effusion) in the winter. Only 17.6% still presented a type B tympanogram in the spring. From the ears with type B tympanogram in the fall, 80% had the same result in the winter, and 60.9%, in the spring. A sharp seasonal SOM peak was observed in the CD group in the winter.
Conclusion:
Children in the lower socioeconomic group have a peak incidence of serous otitis media (OM) in the winter. Presence of type B tympanogram in the fall and belonging to socioeconomic group CD are indicators of poor prognosis in terms of the spontaneous resolution of SOM.